Fill and Sign the Az Llc Search 497297078 Form

CONDITIONAL WAIVER AND RELEASE ON PROGRESS PAYMENT— CORPORATION, LLC, etc. Project: ____________________________________ Job No.: ___________________________________ On receipt by the undersigned of a check from __________________________________ (maker of check) in the sum of $ ___________________ payable to ___________________________________ (amount of check) (payee or payees of check) and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective to release any mechanic's lien, any state or federal statutory bond right, any private bond right, any claim for payment and any rights under any similar ordinance, rule or statute related to claim or payment rights for persons in the undersigned's position that the undersigned has on the job of ____________________________________ (owner) located at ____________________________________ to the following (job description) extent. This release covers a progress payment for all labor, services, equipment or materials furnished to the jobsite or to ________________________________ , (person with whom undersigned contracted) through the _____ day of ______________ , 20 ______ , only and does not cover any retention, pending modifications and changes or items furnished after that date. Before any recipient of this document relies on it, that person should verify evidence of payment to the undersigned. The undersigned warrants that he either has already paid or will use the monies he receives from this progress payment to promptly pay in full all of his laborers, subcontractors, materialmen and suppliers for all work, materials, equipment or services provided for or to the above referenced project up to the date of this waiver. Conditional Waiver and Release on Progress Payment Page 1 of 2 This the _____ day of _________ , 20 ______ . ______________________________ Name of Company By: __________________________ ___ _____ __ Signature Title ______________________________ Type or Print Name AZ § 33-1008 Conditional Waiver and Release on Progress Payment Page 2 of 2